About the BJC ACO


Sandra Van Trease, BJC group president and president, BJC ACO, speaks to patients about the benefit of this expanded focus, and the ability of the patient and physician to share data or have a conversation about care needs.


BJC HealthCare was one of 89 health care provider organizations from across the country chosen as an Accountable Care Organization (ACO). The announcement was made July 9, 2012, by the Centers for Medicare and Medicaid Services (CMS). CMS began establishing ACOs in January 2012 to encourage groups of physicians, hospitals and other providers to coordinate health services for patients covered by Medicare and to share in savings obtained through high-quality, well-coordinated care.

BJC HealthCare was the first ACO in the St. Louis area. Health care information producer and publisher Becker's Hospital Review named BJC HealthCare ACO as one of the current Top 100 Accountable Care Organizations to Know.

It is one of the few ACOs that not only utilize home care as a service provider, but also place it within the ACO governing body. ACO News, a national news source on ACOs, highlighted the BJC HealthCare ACO in a February 2014 article about the expanded benefits of this placement. 

How ACOs Started

Smiling couple in a hug.In October 2011, the Centers for Medicare and Medicaid Services (CMS) finalized new rules under the Affordable Care Act to help doctors, hospitals and other health care providers better coordinate care for Medicare patients.

ACOs create incentives for health care providers to work together to treat patients across care settings -- including doctor’s offices, hospitals and long-term care facilities.

The Medicare Shared Savings Program rewards ACOs that lower health care costs while meeting standards of quality care. For 2012, CMS established 33 quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.

How the BJC ACO is Organized

View our current BJC ACO commercial.

ACO Name and Location

BJC HealthCare ACO, LLC

Suite 300

670 Mason Ridge Center Drive

St. Louis, MO 63141


ACO Primary Contact

Nancy Kadlec, 

Program Director, Accountable Care




ACO Participants

  • Hospitals

  • BJC ACO Physician Offices 

  • BJC Medical Group

  • BJC Home Care Services

  • Participating Physician Practices

    • Ahmad A. Karadaghy, MD

    • Alton MultiSpecialists, Ltd.

    • Associated Specialists in Medicine

    • Aubra Houchin, DO

    • Barnes-Jewish St. Peters Hospital Physician Services

    • Boonslick Medical Group, Inc.

    • Brian Stufflebam, MD

    • CA Group, LLC

    • Christopher M. Perry, DO, PC

    • Comprehensive Spine Care

    • Consultants In Women’s Healthcare, Inc.

    • Fairview Heights Medical Group, S. C.

    • Internal Medicine and Geriatrics Associates

    • Jacquelyn B. Garrett, MD

    • James Goldring, MD

    • Metropolitan Orthopedics, Ltd.

    • Michael J. Adams, DO

    • Mid Missouri Pain Management

    • Midwest Vascular and General Surgery, Inc.

    • Missouri Baptist Medical Center Physician Services

    • MSA Alliance, LLC

    • Nephrology and Hypertension Specialists

    • O.A. Associates, LLC

    • OB Practice, LLC

    • PC Associates, LLC

    • Physician Groups, L.C.

    • Podiatry Associates, Inc.

    • Pulmonary Critical Care Medicine

    • Specialists In Gastroenterology

    • Specialists In Urology

    • Specialty & Primary Care, LLC

    • St. Charles Orthopaedic Surgery Associates

    • St. Louis Cardiology Center, P.C.

    • St. Louis Cardiology Consultants, Ltd.

    • St. Louis Urological Surgeons

    • St. Peters Bone and Joint Surgery

    • Stein Urology, S.C.

    • Stephen E. Kraft, MD

    • Stuart R. Adler, MD

    • Suburban OB/GYN, Ltd.


BJC ACO Governing Body

The ACO's governing body is its Board of Managers, which currently consists of the following individuals:

  • Sandra Van Trease, Voting Member and Chairperson, serving ex-oficio as the President of BJC ACO

  • Dale Nowlin, Voting Member, Medicare Beneficiary Representative

  • Gary Grix, MD, Voting Member, ACO Participant Representative, BJC Medical Group

  • John Antes, Voting Member, ACO Participant Representative, President of Missouri Baptist Medical Center

  • John Ellena, MD, Voting Member, ACO Participant Representative, Fairview Heights Medical Group

  • John Lynch, MD, Voting Member, ACO Participant Representative, Vice President and Chief Medical Officer of Barnes-Jewish Hospital

  • Rick Stevens, Voting Member, ACO Participant Representative, President of Christian Hospital

  • Mark Turner, Voting Member, ACO Particiapnt Representative, President of Memorial Hospitals

  • Hans Mossa, MD, Voting Member, ACO Participant Representative, Medical Director of Memorial Hospitals

  • Douglas Pogue, MD, Voting Member, ACO Participant Representative, President of BJC Medical Group

  • Tony Schwarm, Voting Member, ACO Participant Representative, President of Missouri Baptist Sullivan Hospital

  • Nathan Moore, MD, Voting Member serving ex-oficio as Medical Director of BJC ACO, ACO Participant Representative, BJC Medical Group


Key Leadership Personnel

  • ACO Executive: Sandra Van Trease, BJC ACO President

  • Medical Director: Nathan Moore, MD

  • Compliance Officer: Steven Bernstetter

  • Quality Assurance and Improvement Officer: Douglas Pogue, MD

  • Program Director: Nancy Kadlec

  • Clinical Program Manager: Megan Guinn, RN, BSN

  • Operation Program Manager: Karen Shakiba


BJC ACO Committees

  • Quality Assurance and Improvement: Douglas Pogue, MD, Chair

  • Nominating Committee: Sandra Van Trease, Chair

  • Network Committee: Douglas Pogue, MD, Chair

ACO Composition

  • A network of individual practices of ACO professionals, partnership or joint venture arrangements between hospitals and ACO professionals

Aggregate Amount of Shared Savings/Losses

  • Agreement Period beginning 2012, Performance Year 1: $0

  • Agreement Period beginning 2012, Performance Year 2014: $0

  • Agreement Period beginning 2012, Performance Year 2015: $0


How Shared Savings are Distributed

  • Reinvest in infrastructure: First Dollars, At Cost
  • Distribution to ACO Participants:
  • Physicians: $0
  • Primary Care Physician: $0
  • Specialists: $0
  • BJC Hospitals: $0


Yes, our ACO uses the SNF 3-Day Rule Waiver

  • Garden View Care Center Inc.
  • Meridian Village Association
  • Lutheran Senior Services - at Meramec Bluffs
  • Lutheran Senior Services - Mason Pointe Care Center
  • Lutheran Senior Services - Lenoir Health Care Center
  • Lutheran Senior Services - Laclede Groves
  • Lutheran Senior Services - at Breeze Park
  • Americare at Southbrook Nursing Center LLC
  • Tiger Place, LLC
  • Manor Grove, Inc
  • Mount Carmel Communities, LLC
  • Country Meadows Nursing and Rehab
  • Delmar Gardens of Meramec Valley Operating, LLC
  • Delmar Gardens North Operating, LLC
  • Delmar Gardens of Creve Coeur Operating, LLC
  • Delmar Gardens of South County, Inc.
  • Delmar Gardens on the Green Operating, LLC
  • Delmar Gardens of Chesterfield Operating, LLC
  • Delmar Gardens West Operating, LLC
  • Delmar Gardens O'Fallon Operating, LLC
  • NHC HealthCare - Desloge, LLC
  • NHC HealthCare - Maryland Heights, LLC
  • NHC HealthCare - Macon, LLC
  • NHC HealthCare - St. Charles, LLC
  • Villages of St. Peters, LLC
  • Alton Memorial Hospital
  • Village North, Inc.
  • Bethesda Long Term Care, Inc. (Southgate)
  • Bethesda Long Term Care, Inc. (Bethesda Meadows)
  • Bethesda Long Term Care, Inc. (Dilworth)
  • Memorial Care Center


Quality Performance Results